DR. KENNETH JARVIS (NPI# 1497758197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497758197 |
| Entity Type | Individual |
| Full Name | DR. KENNETH JARVIS |
| Credential | DPM |
| Practice Address |
1200 S 4th St Ste 111 Las Vegas NV 89104-1046 |
| Mailing Address |
4333 Oasis Valley Ave North Las Vegas NV 89085-2335 |
| Practice Telephone | 7028101748 |
| Practice Fax Number | 7028378292 |
| Mailing Telephone | 7028101748 |
| Mailing Fax Number | 7028378292 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 0108 | NV | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | RAILROAD MEDICARE | P00138284 | 01 |
| NV | 100501920 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7350 W Cheyenne Ave, Ste 110, Las Vegas, NV 891297445 | 7022285018 | 7026426775 |
| Street Address |
1200 S 4TH ST STE 111 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89104-1046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548804529 | First Person Care Clinic | Counselor | 1200 S 4th St Ste 111, Las Vegas, NV 89104-1046 | 2019-11-01 |
| 1487215141 | Janice C Owens | Nurse Practitioner | 1200 S 4th St Ste 111, Las Vegas, NV 89104-1046 | 2019-06-24 |
| 1861752701 | Ivonne Draughon | Nurse Practitioner | 1200 S 4th St Ste 111, Las Vegas, NV 89104-1046 | 2012-05-25 |
| 1205021474 | Minnie Elizabeth Wood | Registered Nurse | 1200 S 4th St Ste 111, Las Vegas, NV 89104-1046 | 2007-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316550635 | Comfort Care Senior Services LLC | In Home Supportive Care | 1601 S Sandhill Rd, 62, Las Vegas, NV 89104 | 2020-08-26 |
| 1508484734 | Accessible Space Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1405 South Mojave Rd, Las Vegas, NV 89104 | 2020-07-14 |
| 1003448333 | Shirley Lauren Valenzona-gianan | Pharmacist | Smith's Pharmacy #318, 4965 East Sahara Avenue, Las Vegas, NV 89104 | 2020-02-05 |
| 1427602713 | Alma Lucia Lozano-vargas | Chore Provider | 1785 E. Sahara Ave. Suite 485, Las Vegas, NV 89104 | 2019-07-25 |
| 1396398947 | Martinez Antuan Coates | Psychologist | 1755 Palm St Bld T Apt147, Las Vegas, NV 89104 | 2019-07-23 |
| 1982171518 | Ian Sande | Occupational Therapist | 1500 West Warm Springs Rd, Las Vegas, NV 89104 | 2018-11-01 |
| 1215436563 | A Better Life In Home Care, LLC | Technician | 1810 East Sahara Avenue, Suite 216, Las Vegas, NV 89104 | 2018-02-01 |
| 1891202016 | Nevada Helping Hands LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1810 E Sahara Ave Ste 143, Las Vegas, NV 89104 | 2018-01-09 |
| 1760901581 | Fannie Bell | Counselor | 1800 E. Sahara Suite 104, Las Vegas, NV 89104 | 2017-09-13 |
| 1386162147 | Jaclyn Mustachio | Social Worker | 1860 E Sahara Ave, Las Vegas, NV 89104 | 2017-08-31 |
| Find all providers in zip 89104 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346799640 | Heller Podiatry LLC | Podiatrist | 9628 Gray Cap St, Las Vegas, NV 89123-5826 | 2016-09-27 |
| 1881077451 | Desert Shores LLC | Podiatrist | 2235 N Rampart Blvd, Las Vegas, NV 89128-7640 | 2015-07-01 |
| 1770997405 | Priya Samant | Podiatrist | 7135 W Sahara Ave Ste 201, Las Vegas, NV 89117 | 2014-06-20 |
| 1508152075 | Hope C Markowitz | Podiatrist | 8021 Ryans Reef Ln, Las Vegas, NV 89128-6886 | 2011-06-23 |
| 1710129549 | Mountain Podiatry | Podiatrist | 653 N Town Center Dr Ste 118, Las Vegas, NV 89144-0515 | 2009-03-25 |
| 1114182904 | Ernest Louk | Podiatrist | 7601 Rockfield Dr, Las Vegas, NV 89128-7929 | 2008-07-22 |
| 1982883294 | Sole To Soul Podiatry LLC | Podiatrist | 3815 S Jones Blvd Ste 6, Las Vegas, NV 89103 | 2007-11-02 |
| 1356481501 | Anthony M. Ricciardi Jr. Ltd Inc. | Podiatrist | 7135 W. Sahara Ave., Suite 201, Las Vegas, NV 89117-2828 | 2007-02-07 |
| 1801962121 | Jason W Rockwood | Podiatrist | 105 Mills Ave Ste 100, Las Vegas, NM 87701-4169 | 2006-11-28 |
| 1275619603 | Charles Cody Cull | Podiatrist | 1717 Navajo Lake Way, Las Vegas, NV 89128-3283 | 2006-10-27 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.